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Resuscitation.
Middlesex Pub. Co.
Resuscitation.

Middlesex Pub. Co.

0300-9572

Resuscitation./Journal Resuscitation.
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    Low field magnetic resonance imaging: A ?beds-eye-d? view into hypoxic ischemic brain injury after cardiac arrest

    Sekhon, Mypinder S.Griesdale, Donald E.
    3页
      原文链接:
    • NSTL
    • Elsevier

    Clinical paper Functionality of registered automated external defibrillators

    Jespersen, Sofie SeitKjoelbye, Julie SamsoeeChristensen, Helle CollatzAndelius, Linn...
    6页
    查看更多>>摘要：Aims: Little is known about automated external defibrillator (AED) functionality in real-life settings. We aimed to assess the functionality of all registered AEDs in a geographically selected area and calculate the proportion of historical out-of-hospital cardiac arrests (OHCAs) covered by nonfunctioning AEDs.Methods: In this cross-sectional study we inspected all registered and available AEDs on the island of Bornholm in Denmark. We collected information on battery status (determined by AED self-test) and electrode status, as well as AED availability. We identified all historical OHCAs registered with the Danish Cardiac Arrest Registry on Bornholm during 2016-2019 and calculated the proportion of OHCAs covered by an AED (regardless of functionality status) within <100, <750, and <1800 meters and the proportion of OHCAs covered by non-functioning AEDs.Results: Of 211 registered AEDs, 181 (81.9%) were publicly accessible and functional. The remaining 40 (18.1%) were not functional, primarily due to expired electrodes (42.5%, n = 17), obstacles to AED retrieval (20.0%, n = 8) or failed self-tests (17.5%, n = 7). Of 197 historical OHCAs, nonfunctional AEDs resulted in an OHCA coverage loss of 5.6%, 4.1% and 1.0 % for <100 m, <750 m and <1800 m, respectively.Conclusion: Almost one-fifth of all registered and publicly available AEDs were not functional, primarily due to expired electrodes, failed self-tests or obstacles to retrieving AEDs. One in twenty historical OHCA was covered by a non-functional AED. Although general AED functionality was high, this finding underlines the importance of regular AED maintenance.
      原文链接:
    • NSTL
    • Elsevier

    Way to go: PEA in the in-hospital setting, a step to return of spontaneous circulation

    Noordergraaf, Gerrit J.Venema, Alyssa
    2页
      原文链接:
    • NSTL
    • Elsevier

    Novel pupillary assessment in post anoxic coma

    Coppler, Patrick J.Elmer, Jonathan
    2页
      原文链接:
    • NSTL
    • Elsevier

    Continuous versus routine EEG in patients after cardiac arrest Analysis of a randomized controlled trial (CERTA)

    Urbano, ValentinaAlvarez, VincentSchindler, KasparRuegg, Stephan...
    6页
    查看更多>>摘要：Background: Electroencephalography (EEG) is essential to assess prognosis in patients after cardiac arrest (CA). Use of continuous EEG (cEEG) is increasing in critically-ill patients, but it is more resource-consuming than routine EEG (rEEG). Observational studies did not show a major impact of cEEG versus rEEG on outcome, but randomized studies are lacking. Methods: We analyzed data of the CERTA trial (NCT03129438), including comatose adults after CA undergoing cEEG (30-48 hours) or two rEEG (20-30 minutes each). We explored correlations between recording EEG type and mortality (primary outcome), or Cerebral Performance Categories (CPC, secondary outcome), assessed blindly at 6 months, using uni- and multivariable analyses (adjusting for other prognostic variables showing some imbalance across groups). Results: We analyzed 112 adults (52 underwent rEEG, 60 cEEG,); 31 (27.7%) were women; 68 (60.7%) patients died. In univariate analysis, mortality (rEEG 59%, cEEG 65%, p = 0.318) and good outcome (CPC 1-2; rEEG 33%, cEEG 27%, p = 0.247) were comparable across EEG groups. This did not change after multiple logistic regressions, adjusting for shockable rhythm, time to return of spontaneous circulation, serum neuronspecific enolase, EEG background reactivity, regarding mortality (cEEG vs rEEG: OR 1.60, 95% CI 0.43-5.83, p = 0.477), and good outcome (OR 0.51, 95% CI 0.14-1.90, p = 0.318). Conclusion: This analysis suggests that cEEG or repeated rEEG are related to comparable outcomes of comatose patients after CA. Pending a prospective, large randomized trial, this finding does not support the routine use of cEEG for prognostication in this setting.
      原文链接:
    • NSTL
    • Elsevier

    Inhaled anaesthesia compared with conventional sedation in post cardiac arrest patients undergoing temperature control: A systematic review and meta-analysis

    Parlow, SimonLepage-Ratte, Melissa FayJung, Richard G.Fernando, Shannon M....
    6页
    查看更多>>摘要：Introduction: Patients admitted with return of spontaneous circulation (ROSC) following out of hospital cardiac arrest (OHCA) are often sedated to facilitate care. Volatile anaesthetics have been proposed as alternative sedatives because of their rapid offset. We performed a systematic review and meta-analysis comparing the use of volatile anaesthetics to conventional sedation in this population. Materials: We searched four databases (MEDLINE, Embase, CENTRAL, and Scopus) from inception to January 6, 2022. We included randomized trials and observational studies evaluating patients admitted following ROSC. We pooled data and reported summary estimates using odds ratio (OR) for dichotomous outcomes and mean difference (MD) for continuous outcomes, both with 95% confidence intervals (CIs). We assessed risk of bias using the Newcastle Ottawa Scale and certainty of evidence using GRADE methodology. Results: Of 1,973 citations, we included three observational studies (n = 604 patients). Compared to conventional sedation, volatile agents had an uncertain effect on delirium (OR 0.96, 95% CI 0.68 & ndash;1.37), survival to discharge (OR 0.66, 95% CI 0.17 & ndash;2.61), and ICU length of stay (MD 1.59 days fewer, 95% CI 1.17 & ndash;4.36, all very low certainty). Patients who received volatile anaesthetic underwent a shorter duration of mechanical ventilation (MD 37.32 hours shorter, 95% CI 7.74 & ndash;66.90), however this was based on low-certainty evidence. No harms were described with use of volatile anesthetics. Conclusion: Volatile anaesthetics may be associated with a decreased duration of mechanical ventilation in patients admitted with ROSC however this is based on low-certainty evidence. Further data are needed to assess their role in this population.
      原文链接:
    • NSTL
    • Elsevier

    Airway strategy and ventilation rates in the pragmatic airway resuscitation trial

    Wang, Henry E.Jaureguibeitia, XabierAramendi, ElisabeteNichol, Graham...
    8页
    查看更多>>摘要：Background: We sought to describe ventilation rates during out-of-hospital cardiac arrest (OHCA) resuscitation and their associations with airway management strategy and outcomes. Methods: We analyzed continuous end-tidal carbon dioxide capnography data from adult OHCA enrolled in the Pragmatic Airway Resuscitation Trial (PART). Using automated signal processing techniques, we determined continuous ventilation rates for consecutive 10-second epochs after airway insertion. We defined hypoventilation as a ventilation rate < 6 breaths/min. We defined hyperventilation as a ventilation rate > 12 breaths/min. We compared differences in total and percentage post-airway hyper-and hypoventilation between airway interventions (laryngeal tube (LT) vs. endotracheal intubation (ETI)). We also determined associations between hypo-/hyperventilation and OHCA outcomes (ROSC, 72-hour survival, hospital survival, hospital survival with favorable neurologic status). Results: Adequate post-airway capnography were available for 1,010 (LT n = 714, ETI n = 296) of 3,004 patients. Median ventilation rates were: LT 8.0 (IQR 6.5 & ndash;9.6) breaths/min, ETI 7.9 (6.5 & ndash;9.7) breaths/min. Total duration and percentage of post-airway time with hypoventilation were similar between LT and ETI: median 1.8 vs. 1.7 minutes, p = 0.94; median 10.5% vs. 11.5%, p = 0.60. Total duration and percentage of post-airway time with hyperventilation were similar between LT and ETI: median 0.4 vs. 0.4 minutes, p = 0.91; median 2.1% vs. 1.9%, p = 0.99. Hypo-and hyperventilation exhibited limited associations with OHCA outcomes. Conclusion: In the PART Trial, EMS personnel delivered post-airway ventilations at rates satisfying international guidelines, with only limited hypo-or hyperventilation. Hypo-and hyperventilation durations did not differ between airway management strategy and exhibited uncertain associations with OCHA outcomes.
      原文链接:
    • NSTL
    • Elsevier

    Early brain imaging after cardiac arrest: Beware the red flags

    Benghanem, SarahCariou, Alain
    2页
      原文链接:
    • NSTL
    • Elsevier

    A method for continuous rhythm classification and early detection of ventricular fibrillation during CPR

    Kwok, HeemunCoult, JasonBlackwood, JenniferSotoodehnia, Nona...
    8页
    查看更多>>摘要：Aim: We developed a method which continuously classifies the ECG rhythm during CPR in order to guide clinical care. Methods: We conducted a retrospective study of 432 patients treated following out-of-hospital cardiac arrest. Continuous ECG sequences from two-minute CPR cycles were extracted from defibrillator recordings and further divided into five-second clips. We developed an algorithm using wavelet analysis, hidden semi-Markov modeling, and random forest classification. The algorithm classifies individual clips as asystole, organized rhythm, ventricular fibrillation, or Inconclusive while integrating information from previous clips. Classifications were compared to manual annotations to estimate accuracy in an independent validation dataset. Continuous sequences were classified as shockable, non-shockable, or Inconclusive; classifications were used to compute shock sensitivity and specificity. Results: Of 432 patient-cases, 290 were used for development and 142 for validation. In the 12,294 validation ECG clips during CPR, accuracies were 0.88 (95% CI 0.85 & ndash;0.91) for asystole, 0.98 (95% CI 0.98 & ndash;0.99) for organized rhythm, and 0.97 (95% CI 0.96 & ndash;0.97) for ventricular fibrillation, with 43% classified as Inconclusive. Of 457 continuous sequences, shock sensitivity was 0.90 (95% CI 0.86 & ndash;0.93), shock specificity was 0.98 (95% CI 0.93 & ndash;0.99), and 7% were Inconclusive. Median delay to ventricular fibrillation recognition was 10 (IQR 5 & ndash;32) seconds. Conclusion: A novel algorithm continuously classified the primary resuscitation rhythms & mdash;asystole, organized rhythms, and ventricular fibrillation & mdash; with 88 & ndash;98% accuracy, enabling accurate shock advisory guidance during most two-minute CPR cycles. Additional investigation is required to understand how algorithm implementation could affect rescuer actions and clinical outcomes.
      原文链接:
    • NSTL
    • Elsevier

    The importance of a long-term follow-up after out-of-hospital cardiac arrest

    Compagnoni, SaraBaldi, EnricoGentile, Francesca RomanaSavastano, Simone...
    1页
      原文链接:
    • NSTL
    • Elsevier